A former Griffith general practitioner has been placed under strict conditions by the Medical Board after it found he had improperly prescribed high-strength painkillers.
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Dr Mehdi Khalighimonfared worked as a GP at Griffith Medical Centre from July 25, 2016 to December 8, 2017 and currently works at a centre at Five Docks in Sydney.
Dr Khalighimonfared prescribed fentanyl, which is 80 times stronger than morphine, as well as the commonly abused drug OxyContin to five patients in Griffith despite signs they were becoming dependent on painkillers.
Dr Khalighimonfared also failed to seek approval from the secretary of NSW Health to provide ongoing access to addictive medications for some of the patients.
On Monday last week, Dr Khalighimonfared was found guilty of unsatisfactory professional conduct and professional misconduct at the NSW Civil and Administrative Tribunal.
The Health Care Complaints Commission proved Dr Khalighimonfared failed to properly assess patients prior to prescribing controlled painkiller drugs, failed to recognise "drug-seeking behaviour" and proceeded to write prescriptions that were not clinically appropriate.
Dr Khalighimonfared breached the medical code of conduct at Griffith and several Sydney suburbs.
On March 22, 2018 a Griffith pharmacist complained to NSW Health's Pharmaceutical Regulatory Unit that Dr Khalighimonfared had prescribed "significant quantities of Schedule 8 opioids".
The Griffith pharmacist noted that Dr Khalighimonfared appeared to be unaware that he was required to handwrite the name and quantity of medications on a computer-generated Schedule 8 prescription.
Schedule 8 opioids include strong medications for chronic pain and possession of these drugs is illegal without a prescription.
A Griffith patient told Dr Khalighimonfared that she had been assaulted by the Taliban in Afghanistan while in her early 20s and suffered fractures to her skull, neck and back.
Dr Khalighimonfared prescribed her OxyContin and later fentanyl skin patches despite her admitting to using her husband's prescribed painkillers.
In his defence, Dr Khalighimonfared testified that he was attempting to wean the patient off opioid drugs and had referred to her to a pain clinic but her treatment had been complicated by PTSD and depression.
"She was more difficult to communicate with due to her culture, for example, no eye contact, she talks to her husband and he talks, consultations with her take twice as long," Dr Khalighimonfared told NCAT.
Another patient repeatedly told Dr Khalighimonfared that his fentanyl patches had fallen off in the bath or had been stolen, or that his prescription had caught fire.
Dr Khalighimonfared also saw another patient 22 times between October 25 and December 2017 and prescribed him fentanyl without checking the man's background, which would have revealed he was taking part in a methadone program.
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A Sydney homeless shelter had also written a letter that assessed the patient as being someone likely to seek drugs from doctors for the purpose of abusing them.
In his defence, Dr Khalighimonfared testified that complaints from the Health Care Complaints Commission had prompted him to enhance his knowledge base and improve his prescribing practices.
Dr Khalighimonfared said he had completed education on pain management and use of opioid medications and had successfully treated patients with acute or chronic pain without powerful opioids since restrictions were imposed upon his practice in 2019.
Dr Khalighimonfared's solicitors submitted that he had a 'knowledge gap' around opioid dependency as he had received no training on the subject in his native Iran, where he received his first medical qualifications in 2004.
"It was my responsibility to address my knowledge gap," Dr Khalighimonfared told NCAT.
NCAT reprimanded Dr Khalighimonfared under Health Practitioner Regulation Law in NSW and placed conditions on his registration that he be supervised while practising and to not possess, supply, administer or prescribe any drug of addiction.
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